#3513 of 11K

A9153

HCPCS Procedure Code

HCPCS code A9153 is the #3,513 most-billed Medicaid procedure code, with $1.6M in payments across 36K claims from 2018–2024. The national median cost per claim is $45.63. Costs vary widely — the 90th percentile is $114.07 per claim, 2.5× the median.

Total Paid

$1.6M

0.00% of all spending

Total Claims

36K

Providers

Avg Cost/Claim

$44

National Cost Distribution

How much do providers bill per claim for A9153? Based on 62 providers billing this code nationally.

Median

$45.63

Average

$58.68

Std Dev

$41.35

Max

$213.90

Percentile Distribution (Cost per Claim)

p10

$19.39

p25

$28.82

Median

$45.63

p75

$82.63

p90

$114.07

p95

$129.41

p99

$176.17

50% of providers bill between $28.82 and $82.63 per claim for this code.

90% bill between $19.39 and $114.07.

Top 1% bill above $176.17.

About This Procedure

HCPCS code A9153 was billed by 64 providers across 36K claims, totaling $1.6M in Medicaid payments from 2018–2024. This code was used for 31K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$45.63

Providers Billing

National Spending

$1.6M

Avg/Median Ratio

1.29×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A9153

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	University Of Utah Salt Lake City, UT · Clinic/Center, Dental	$162K	$125.60	2.8× median	Top 10%
2	Berry Family Services Rowlett, TX · Case Management	$140K	$103.79	2.3× median	Above 75th
3	D&s Residential Services, Lp Austin, TX · Intermediate Care Facility, Intellectual Disabilities	$129K	$40.92	0.9× median	Below Median
4	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$93K	$19.28	0.4× median	Below Median
5	Kenmar Residential Hcs Services Inc. Round Rock, TX · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	$69K	$68.97	1.5× median	Above Median
6	1841409307	$58K	$51.04	1.1× median	Above Median
7	Abiding Choice Inc Rockdale, TX · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	$55K	$120.22	2.6× median	Top 10%
8	1790860666	$50K	$24.62	0.5× median	Below Median
9	1700926987	$50K	$65.78	1.4× median	Above Median
10	1205037066	$45K	$37.11	0.8× median	Below Median
11	1871704544	$41K	$40.22	0.9× median	Below Median
12	Daybreak Community Services Texas Llc Fort Worth, TX · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities	$39K	$49.29	1.1× median	Above Median
13	1710014618	$35K	$91.46	2.0× median	Above 75th
14	1336340157	$33K	$49.40	1.1× median	Above Median
15	1871794933	$33K	$25.86	0.6× median	Below Median
16	1417156100	$32K	$56.66	1.2× median	Above Median
17	1225239387	$29K	$63.86	1.4× median	Above Median
18	Texana Center Rosenberg, TX · Counselor, Mental Health	$28K	$93.13	2.0× median	Above 75th
19	1427259241	$24K	$23.79	0.5× median	Below Median
20	1295944759	$23K	$32.75	0.7× median	Below Median

Showing top 20 of 64 providers billing this code

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